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目的:探讨经皮肾镜取石术(PCNL)后出血的超选择性肾动脉栓塞治疗(SRAE)的临床经验和技巧。方法:我院2007年1月~2014年9月期间施行PCNL手术者2 306例,其中术后发生出血保守治疗失败后行SRAE治疗者10例,结果:10例患者中,肾动脉假性动脉瘤5例,肾动静脉瘘4例,阳性率90%,均栓塞后成功。1例患者两次肾动脉造影均未见明显出血部位,拔除肾引流管后保守治疗成功。结论:SRAE治疗PCNL术后假性动脉瘤或动静脉瘘出血者疗效显著,符合指征者宜早治疗;充分掌握SRAE的技巧有利于提高阳性率和成功率。
Objective: To investigate the clinical experience and skills of super selective renal artery embolization (SRAE) after hemorrhage after percutaneous nephrolithotomy (PCNL). Methods: A total of 2 306 PCNL surgeries were performed from January 2007 to September 2014 in our hospital. Among them, 10 cases underwent SRAE after conservative treatment failure. Results: In 10 cases, the renal arteries 5 cases of tumor, 4 cases of renal arteriovenous fistula, the positive rate of 90%, were successful after embolization. One case of patients with renal artery angiography showed no obvious bleeding sites, conservative treatment of the successful removal of the renal drainage tube. Conclusion: SRAE treatment of pseudoaneurysm or arteriovenous fistula bleeding after PCNL significant effect, in line with indications should be treated early; adequate grasp of the skills of SRAE help to improve the positive rate and success rate.